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Facilitated enrollment offers a potential solution to some administrative burdens and choice frictions that may produce incomplete take-up of marketplace coverage. Because Covered California, California's ACA individual marketplace, and Medi-Cal, California's Medicaid program, share an eligibility system, Covered California has the ability to identify individuals who are eligible for marketplace coverage upon losing Medicaid eligibility.
This evaluation will compare the effectiveness of facilitated enrollment strategies, including personalized plan pre-selection and personalized quotes of net premiums, to other enhanced, but general outreach tactics, on marketplace take-up among individuals losing Medi-Cal coverage.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control group | No Intervention | A control group that receives a standard eligibility notice informing them of their eligibility for marketplace coverage. | |
| Enhanced Outreach | Experimental | A treatment group that receives a standard eligibility notice informing them of their eligibility for marketplace coverage and an informational flyer describing what Covered California is, the availability of financial assistance, and information on benefit design and private insurance terminology, such as deductibles and copays. |
|
| Pre-Selected Plan | Experimental | A treatment group that receives a modified eligibility notice that includes information on the pre-selected lowest-cost silver health insurance plan with a personalized quote for their net premium amount, as well as the informational flyer. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Informational flyer | Behavioral | In addition to a standard eligibility notice informing participants of their eligibility for marketplace coverage, they receive an informational flyer describing what Covered California is, the availability of financial assistance, and information on benefit design and private insurance terminology, such as deductibles and copays |
| Measure | Description | Time Frame |
|---|---|---|
| Enrollment | a binary indicator for whether a consumer has at least one month of effectuated coverage a Covered California plan that started within the 90 days of their Special Enrollment Period (SEP) following loss of Medi-Cal coverage | within calendar year since the loss of Medicaid |
| Measure | Description | Time Frame |
|---|---|---|
| Tenure | Tenure with Covered California (measured in months) | within 1-2 years after treatment assignment |
| Uninsured | A binary indicator for whether someone self-reported being uninsured while filing their taxes; |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Covered California | Sacramento | California | 95620 | United States |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | May 2, 2024 | Nov 15, 2024 | Prot_SAP_000.pdf |
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| Modified eligibility notice with plan information | Behavioral | a modified eligibility notice that includes information on the pre-selected lowest-cost silver health insurance plan with a personalized quote for their net premium amount in addition to the informational flyer and instead of a standard eligibility notice |
|
| within 1-2 years from the treatment assignment |
| Consumer engagement | A binary indicator for consumer engagement including calls to service center, creation of and logins to user account, plan shopping on the website, agent delegation after eligibility determination; | within 90 days from the treatment assignment |
| Office visit | A binary indicator for whether someone had an office visit to the medical practitioner during 1-2 years since the intervention; | during 1-2 years since the treatment assignment |
| Prescription filled | A binary indicator for whether someone had a prescription drug fill during 1-2 years since the intervention; | during 1-2 years since the treatment assignment |
| Emergency room visit | A binary indicator for whether someone had an emergency room or department visit during 1-2 years since the intervention | during 1-2 years since the treatment assignment |
| Hospital admission | A binary indicator for whether someone had a hospital admission 1-2 years before and during 1-2 years since the intervention | 1-2 years before and during 1-2 years after the treatment assignment |
| Out-of-pocket health care spending | Total out-of-pocket spending for the 1-2 years since the intervention | during 1-2 years since the treatment assignment |